Wang Tong-Mei, Lin Yu-Chun, Lan Yi-Hao, Lin Li-Deh
School of Dentistry, National Taiwan University, Taipei, Taiwan.
Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Dent Sci. 2022 Apr;17(2):897-902. doi: 10.1016/j.jds.2021.12.013. Epub 2022 Jan 3.
BACKGROUND/PURPOSE: Bone quality may affect the implantation protocol. This study aimed to assess whether training protocols could improve novice dental practitioners' abilities in judging bone densities with tactile sensation.
Twenty-five operators were recruited to evaluate the density of artificial polyurethane bone blocks by a 2-mm twist-drill drilling and reported the bone quality perceived in a 100-mm VAS line. Five blocks (densities: 0.08-0.48 g/cm) were used to simulate cancellous bone with extremely low to medium-high densities. Five tests were performed on three days, separated by one week and one month. A training session was arranged on the first day and the third day. In each test, the operator drilled a 0.8 g/cm block as the reference (VAS = 100) and then the five test blocks in a randomized sequence. Each training session included a 0.8 g/cm followed by five 0.16 and 0.32 g/cm alternative block-drillings. VAS values and number of density-sequencing errors were analyzed with GLM repeated measures and Friedman test.
While mean VAS values were significantly different among the five test blocks, it was not noticed in blocks of the same density between test sessions. Significant linear correlations were observed between VAS values and block densities. Training did not influence the VAS evaluation and hardness sequencing in general but training significantly reduced the sequencing errors in operators with inferior initial performance.
The proposed training protocol can improve the bone-quality perception among less experience dentists with poorer initial performance in bone density evaluation.
背景/目的：骨质量可能会影响种植方案。本研究旨在评估培训方案是否能提高新手牙科医生通过触觉判断骨密度的能力。
招募25名操作者，通过2毫米麻花钻钻孔来评估人工聚氨酯骨块的密度，并在100毫米视觉模拟评分（VAS）线上报告所感知的骨质量。使用五个骨块（密度：0.08 - 0.48克/立方厘米）来模拟极低到中高密度的松质骨。在三天内进行五次测试，间隔一周和一个月。在第一天和第三天安排了培训课程。在每次测试中，操作者先钻一个0.8克/立方厘米的骨块作为参考（VAS = 100），然后以随机顺序钻五个测试骨块。每次培训课程包括先钻一个0.8克/立方厘米的骨块，然后交替钻五个0.16和0.32克/立方厘米的骨块。使用广义线性模型重复测量和弗里德曼检验分析VAS值和密度排序错误的数量。
虽然五个测试骨块之间的平均VAS值有显著差异，但在不同测试阶段相同密度的骨块中未观察到差异。VAS值与骨块密度之间存在显著的线性相关性。一般而言，培训并未影响VAS评估和硬度排序，但培训显著减少了初始表现较差的操作者的排序错误。
所提出的培训方案可以提高在骨密度评估方面初始表现较差、经验较少的牙医对骨质量的感知。
